DuBOIS — Dr. Suzanne Iorfido, a Penn Highlands DuBois radiologist who specializes in breast imaging, told those attending Saturday’s PHH Women’s Expo that, unfortunately, breast cancer is very common.
Two American Cancer Society statistics which really hit home in that regard, said Iorfido, are:
- One in eight women will be diagnosed with breast cancer in their lifetime.
- Every two minutes in the United States a woman is diagnosed with breast cancer.
“When we look for breast cancer, our level of suspicion is very high in every woman regardless of a woman’s age, ethnicity, family history,” said Iorfido, who is also a specialist in intervention and the diagnosis of breast cancer. “An important point to remember is that most women diagnosed with breast cancer have no family history of breast cancer. That just speaks to how common the disease is.”
Iorfido said mammograms, in general, are the best way to diagnose breast cancer.
For women, age 40 and over, it is recommended that they should have a mammogram every year, she said.
“You should have a mammogram sooner though, if there is any type of question of abnormality in the breast, whether that be before the age of 40, particularly in woman in their 30s who are maybe not quite thinking about mammograms yet,” Iorfido said. “If there’s anything potentially concerning or anything that you’re questioning, it’s a good idea to talk to your doctor and perhaps have that breast imaging performed.”
Things to look for include a new lump or a bump in either breast, any area of hardness or firmness or different areas of pain, said Iorfido, noting that particularly areas of pain that are focal and are persistent.
“Any form of skin changes, a puckering in or retracting skin, whether that skin is the skin of the breast or the nipple itself, changes to the nipple, any type of rash that maybe doesn’t go away, a redness or a crustiness to the nipple that doesn’t go away,” she said.
“The other thing would be an axilla, that’s an important point as well,” said Iorfido. “A lump in the axilla that doesn’t go away, will have those lymph nodes that can sort of wax and wane. For instance, most recently with our COVID vaccinations you may have noticed that, but that should go away. If it’s something that persists or is different, it’s definitely worth getting checked out.”
She said the point of yearly screening mammograms is to find breast cancers before “you as the patient or your doctor” notice them.
“Usually a mass in the breast has to be about two centimeters or larger for it to be felt in a physical exam. The point of a mammogram screening every year is to find breast cancers before that,” she said. “Thankfully we can find and diagnose breast cancers at about half a centimeter on a screen mammogram. The newer type of mammograms are called 3D mammograms tomosynthesis, that shows us even smaller, more subtle images. What we’re able to do is look at the breast slice by slice, layer by layer and really get a clear picture of the breast tissue.”
Iorfido said this is particularly important in women with dense breast tissue.
“There is a lot of talk about this. You can broadly categorize it as dense or non-dense, so each woman would fall into one of those categories,” she said. “When you talk about density, that dense category is important for a few different reasons. One is sensitivity in general, the other is that in and of itself that tissue will put that woman at a higher risk for developing breast cancer. The way that we can think about this is on a mammogram, breast cancer typically starts as a white nodule area that will arise or increase in size on the mammogram. When there is dense breast tissue, think of it sort of as though somebody takes a paint brush with white paint and just kind of goes over a mammogram. So you can see how that dense tissue can obscure an area that is growing, it can hide it and even make it invisible. That would be called a mammographically occult breast cancer.”
That’s really where ultrasounds come in, she said.
“Ultrasounds are a beautiful compliment to mammograms because they can see through that dense tissue,” said Iorfido.
She said early breast cancer is easier to treat and cure.
“In hopes of facilitating this early detection, we send women letters every year, reminding them when they’re due for their annual mammogram, it probably feels like that year goes really quickly, but we know that breast cancers can arise in that interval,” said Iorfido.
When a woman is diagnosed with breast cancer, it’s normal for them to think how will they get through this, she said.
“But you do not have to look far to find breast cancer survivors — our friends, our family members,” said Iorfido.
She said she often watches the “Today Show” in the morning when getting ready for work.
“If you’re familiar with Hoda Kotb the anchor, she is a breast cancer survivor, she was age 43, never had a mammogram and they found the lump on her routine exam,” said Iorfido. “She (Kotb) talks about how she had a hard time at first wrapping her head around the diagnosis, and she had no family history of breast cancer, really wasn’t something that she was thinking about. She said that somebody had said something earlier in her breast cancer journey that really stuck with her. That person had said: ‘I know a lot of women who have had breast cancer and the thing that they all have in common is that they’re all still here.’ And thankfully that is the case for a lot of women.”
That is not the case for all women, though, she said. And for that reason, early detection and early treatment is so important.
Throughout the Penn Highlands health system, breast care professionals are here to support patients for years to come. To learn more (or make that call and schedule a scan), visit www.phhealthcare.org/pink.